Individual provider Active NPI

Lisa Dawn Maskill, M.D.

  • Pediatric Orthopaedic Surgery Physician
  • Grand Rapids, MI
National Provider Identifier
1962611277
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
4301085936 Issued in MI
Practice address
35 Michigan St NE
Ste. 4150
Grand Rapids, MI 49503-2514
Phone
(616) 267-2600
Fax
(616) 267-2601
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Orthopaedic Surgery Physician 207XP3100X A112336 CA
Pediatric Orthopaedic Surgery Physician 207XP3100X 4301085936 MI Primary

Addresses

Primary practice location

35 Michigan St NE
Ste. 4150
Grand Rapids, MI 49503-2514

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560

Other practice location 1

235 Wealthy St SE
Grand Rapids, MI 49503-5247
Phone (616) 840-8000

Other names 1

  • Dr. Lisa Dawn Hagrelius Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address Lisa.Maskill@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110826000430 MI Practitioner - Orthopedic SurgeryPractitioner - Pediatric Medicine 3971636606 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A112336CAMDPediatric Orthopaedic Surgery Physician
4301085936MIMDPediatric Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners Orthopaedic Surgery Current Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Aug 31, 2011 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Aug 31, 2011 Accepting new patients
Spectrum Health Hospitals Past Accepting new patients

Locations

35 Michigan St NE
Ste 4150
Grand Rapids, MI 49503
Phone (616) 267-2100

235 Wealthy St SE
Grand Rapids, MI 49503
Phone (616) 242-0422

100 Michigan St NE
Ste MC845
Grand Rapids, MI 49503

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

35 Michigan St NE
Ste 3003
Grand Rapids, MI 49503
Phone (616) 267-2200

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

3220 Discovery Dr
Ste 210
Lansing, MI 48910
Phone (517) 484-0004

3960 Patient Care Dr
Ste 113
Lansing, MI 48911
Phone (517) 702-3200

3950 Hollywood Rd
Ste 240
Saint Joseph, MI 49085
Phone (269) 408-1852

550 Munson Ave
Ste 202
Traverse City, MI 49686
Phone (231) 935-7548

Interoperability endpoints

  • Direct secure messaging: lmaskill51780@epic00.corewelldirect.org
  • Direct secure messaging: lisa.maskill@epic00.shdirect.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1962611277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 MICHIGAN ST NE",
            "address_2": "STE. 4150",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032514",
            "telephone_number": "616-267-2600",
            "fax_number": "616-267-2601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "235 Wealthy St SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495035247",
            "country_code": "US",
            "telephone_number": "616-840-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASKILL",
        "first_name": "LISA",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "CA",
            "license": "A112336",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "MI",
            "license": "4301085936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Lisa.Maskill@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "35 Michigan St NE",
            "address_2": "Ste. 4150",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032514",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "35 Michigan St NE",
            "address_2": "Ste. 4150",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "HAGRELIUS",
            "middle_name": "DAWN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.